I had taken this list a while back from a document I can't seem to locate anymore that used to be on either the ILCA or IBLCE website.....anatomy and physiology, endocrinology, nutrition, biochemistry, immunology and infectious disease, pathology, pharmacology, pychology, sociology, anthropology, human development, research, ethics, public health, education, counseling, teaching, social justice, writing and communication, ethics, advocacy, professionalism, as it all relates to maternal child health.....and lactation of course! I know there's more...and not one common discipline that I can think of that addresses each of these topics as part of a degree requirement (I think now we have some, unfortunately rare, degree programs that accomplish this or are in the process of working toward this type of a degree...but they are exceedingly rare at this point)....

I think that nursing education and the other disciplines mentioned, counseling, education, public health, are all very related to satisfying parts of this background education that is necessary to perform these tasks.

I suspect one of the reasons that nurses constitute a large portion of the IBCLC's in the US is the ease in which they may accumulate the clinical hours if they work in a birth center (not implying that the job itself is easy!). Just a circumstance that is nicely suited to satsify the requirements and earn the hours while in the existing workplace. If a person interested in certifying as an IBCLC is currently employed in a capacity that doesn't provide them with the ability to simultaneously earn their living and earn the clinical hours, adding the time it takes to earn clinical hours can be a very big obstacle (less so now that the hours are reduced, but still may be challenging to coordinate the preceptor relationship)...or even finding a preceptor willing to facilitate the process can be challenging! I know many of you have accomplished this and you are to be applauded! Nonetheless it is an obstacle to many. The reality that greater than 95% of all births in the US take place in a hospital setting makes the services of an IBCLC an understandably desireable resource in this setting. Of course strengthening our approach will include improving the resources within and outside of the hospital setting, reducing disparities in terms of access to resources for all mothers and babies and increasing the ease in which mothers may access resources in their community and home.

There are other options as well, one of my friends has a strong desire to woprk with breastfeeding mothers and babies further, and certify as an IBCLC, has a background in MCH, and is considering applying for becoming a LLL Leader. As she reviewed the requirements to qualify to sit the IBLCE exam she noted the yearly hours she would earn as a LLL Leader and was concerned that 500 hrs/yr figure averages out to @ 10 hours a week. Although she would love to serve moms and babies in this role, she was feeling deterred by her anxiety related to carving out another 10 hours a week in addition to her existing job and family commitments.

Don't get me wrong! Of course the hours are vital, necessary and warranted! I hope everyone reads this far! The point I am trying to make is that it does potentially reduce some of the anxiety surrounding the process (and increase the appeal) if you are in a position to earn the clinical hours through existing employment.

Michelle H. Kinne ICCE CD(DONA) CLE
www.DoulaDiva.org

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